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Learning from the Past: The 1918 Flu Pandemic in Kansas City

By Diane Euston

It seemed to come from nowhere, and doctors at the time had little treatment for it. It was unclear how it even was transmitted, as the theory about germs was in its infancy.

Many historians call the influenza outbreak in 1918 the “forgotten pandemic.” Even though everyone in the United States was affected in some way, the public over time forgot about it–but scientists didn’t forget.

The lessons learned from what was labeled the Spanish Flu should have laid the course for what and what not to do during a pandemic. Kansas City in particular suffered harder than most large cities due to divided politics, mixed messages, and a raging World War.

Soldiers suffering from influenza at the hospital in Camp Funston, Kansas in 1918. Camp Funston was where the influenza epidemic which would kill more than 50 million people world-wide, including 675,000 Americans, first made a major appearance. Troops from the camp carried the virus to other Army bases during World War I. ( National Archives)

The Alleged Beginning of the Flu

In January 1918, rural Haskell County in the southwestern corner of Kansas was facing a serious problem. Practically overnight, people were reporting severe symptoms. The newspaper reported, “Most everybody over the country is having lagrippe or pneumonia.”

Shortly after, several young men kissed their mothers goodbye and headed to Camp Funston at Fort Riley, Ks. to be trained in the Army to fight overseas in World War I. They didn’t just take their luggage with them, they were likely carrying with them a deadly strain of influenza. By the beginning of March, 1,100 soldiers came down with it at Camp Funston. Because of the war effort, these soldiers carried the virus to other Army camps. Before getting a one-way ticket to the battlefields in Europe, influenza infected at least 24 of the large Army camps and spread to nearby communities.

The United States stayed quiet as the virus virtually spread like wildfire – no one wanted the enemy to know that soldiers were weakened by sickness. By the time it reached Europe and crossed the invisible borders into Spain, millions of people had been infected. Spain was neutral during World War I, so they openly reported the outbreak while other countries downplayed the problem. In turn, this new, deadly strain of influenza was given a name–the Spanish Flu.

Kansas City’s Political Boss Problem

By 1918, Kansas City’s population was around 250,000. Because of rapid population growth, the city was congested. Many boarding houses crammed tenants into them, and modern plumbing was a luxury. The absence of sufficient bathing houses, running water and lack of personal hygiene was the perfect breeding ground for a deadly virus.

Boss Tom Pendergast (1872-1945)

The people making political decisions were a part of the “Democratic Machine.” Joe Shannon and Tom Pendergast had at one time been at odds for control of politics but had agreed to work together to elect “their people” into office. Mayor James Cowgill was one of these people, and after being put into office, Pendergast and Shannon split appointments of government offices in half so each could have equal control over the police and fire departments, the City Council and even the Health Board.

Kansas City had one public hospital called General Hospital that had about 350 beds. The head of the hospital was Dr. E.H. Bullock, and he was appointed director of the Health Board. The president was W.D. Motley, and most everyone on the Board were people who “worked” for the bosses. The political setup in Kansas City would directly affect the way these men would respond to a public health crisis in 1918.

The First Days of the Flu in Town

Although influenza had attacked the Army and other communities in March and April, Kansas City seemed to have avoided any direct threat to the virus. When the second wave of the flu emerged in late September, it crept into Kansas City and wreaked havoc.

Starting in the city’s two Army motor corps schools, the first cases of the disease were immediately put in quarantine but the damage was done. The soldiers had been in contact with some young ladies, and shortly thereafter, they came down with the illness. According to the University of Michigan, “By October 1, twenty percent of the city’s army training schools had contracted influenza. Forty-three civilian cases had appeared, with 33 of them under isolation.”

Dr. Bullock acknowledged the cases but said it was “not yet dangerous.” Five days later, 24 deaths were reported in one day. General Hospital was already crowded and people were being turned away.

Treatment for the Flu

In the 19th century, no degree was required to enter medical school and there were various theories of disease transmission. When the flu broke out, it didn’t get diagnosed correctly at first because the symptoms were so unique.

Instead of infecting the young and old, this strain was killing young, healthy men and women at their prime. Patients experienced a quick onset of a high fever, a wet cough that brought up blood, and their faces would turn blue. Within 24 to 48 hours, many would succumb to the illness.

Treatment at the time was varied. Young doctors better trained in medicine had enlisted in the war, leaving a shortage of them throughout the nation. The Army saw quarantine as the best way to fight the disease. Susan Debra Sykes Berry, who wrote a thesis on the pandemic in Kansas City, explained, “Quarantine was one of the best public health measures, and most Army doctors were aware that a 21-day period was the ideal.”

Many people used remedies spanning back to Egypt and wore onions and garlic around their necks. Some believed eating them was even more effective. Non-smokers began smoking, thinking it would choke out the disease. Others thought eating yeast would do the trick, and many ended up with terrible stomach aches as a result.

The best remedy for influenza was care which included drinking fluids, keeping warm and trying to lower the patient’s temperature. Many doctors recommended aspirin or quinine and ordered patients to stay home.

List of remedies for the flu published by the Kansas City Star Oct. 6, 1918

Slow to the Program

Even as the flu ravaged through Kansas City by October 6, there were no orders issued by the Health Board except for “asking” places where people congregate (such as theaters, churches and streetcars) to disinfect surfaces at night. They offered suggestions such as staying out of crowds, keeping bowels active by laxatives, getting plenty of sleep, and keeping warm by proper dressing, just to name a few.

Since the Health Board in Kansas City wasn’t leading, an unexpected group stood up and demanded action. The Chamber of Commerce asked for a meeting with the mayor and Health Board. Closing businesses to the public would directly hurt the Chamber, but they argued that the lives of Kansas Citians were more important. Businessman R.A. Long said, “I’d feel like a criminal, personally, if I were a businessman and insisted on keeping open in a time like this. If the epidemic grips your own household you will then commence to know what human life means as compared to money.”

It was agreed after the meeting on Oct. 7 to forbid gatherings of more than 20 people, and they closed schools the next day.

On the Kansas side of the state line, the mayor took swift action and closed schools, churches, and theaters. All public gatherings of all kinds were prohibited until “after the danger from the disease has passed.” For the most part, Kansas never lifted their quarantine.

Freedom from Quarantine

The minute that there was a decrease in cases in a 24-hour period, Kansas City resumed talks to lift the ban. To no surprise, saloons were still open and quite crowded. Because the Democratic Machine was directly involved in saloons and also controlled the police, they went about business as usual knowing that no action would be taken. Many even boasted signs at the back of bars claiming the flu could be fought “with quinine and whisky,” but the Kansas City Star noted, “The saloons continued to work extra bartenders to accommodate crowds- not for advised quinine- but for tall steins of ‘suds.’”

Just one week after placing a ban on crowds (which was not enforced), the Health Board and the mayor lifted it despite that most physicians didn’t agree. Major Dutton with the Red Cross stated, “I consider it very unwise to lift the ban. The history of other epidemics shows this to be the critical time. To lift the ban now is to invite the return of the epidemic.”

Health Board president W.D. Motley responded that if lifting the ban was a mistake, they could “rectify it later on” while another man present warned, “A dead man cannot accept apologies.”

Schools in Kansas City, Mo. decided to remain closed for a week longer despite the lift on the ban. On Oct. 15, 106 new cases were reported at General Hospital followed by 113 the next day.

General Hospital (1908-1976) at 23rd and Gillham. Courtesy Missouri Valley Special Collections, KCPL.

A Ban Once Again

The Chamber of Commerce was irate when the ban was lifted and saw a growing problem in the streets of Kansas City. They saw that neighboring communities were still under quarantine, so those people were coming to Kansas City for entertainment. Head of contagious diseases in Kansas City Dr. A.J. Gannon claimed, “The responsibility of preventing [the flu’s] spread should be assumed by the individual.” The concerns of the Chamber worked to change their minds; a second ban closing nonessential businesses was ordered on Oct. 17 but exempted “war industries, butcher shops, grocery and drug stores.”

An editorial the following day in the Kansas City Star was critical of those in charge, specifically Mr. Motley, president of the Health Board. They wrote, “Throughout the epidemic, he has acted much more like a representative of the interests that would have put their own profits above human lives, rather than like the guardian of public health.”

Mayor James Cowgill (1848-1922)

Three weeks later on Nov. 8, Mayor Cowgill commented that the present ban “is needlessly hampering businesses.” He then lifted the ban and only required that streetcars still limit capacity. Theaters reopened and crowds went back to normal on the streets.

Nov. 11 welcomed Armistice Day, and Kansas City had over 100,000 people crowding the streets of the city in celebration of the end of the war. One week later, schools reopened for the first time in five weeks.

The biggest problem was that cases were still being reported at a steady pace, but due to the want to stimulate the economy and the Democratic Machine’s pocketbooks, politics took a front seat to public health. By Nov. 16, all bans in Kansas City had been lifted by the mayor.

When new cases spiked on Nov. 26, it was attributed to schools being reopened. The flu raged on, forcing schools to close once again on Nov. 30. The day before, a record 414 cases were reported in one day. The damage had been done.

Mitigating the Damage

It was clear the misguided leadership of city officials created confusion and caused more harm in the long run. Kansas City was becoming one of the deadliest cities in the nation with cases and deaths on the rise. Children under 16 were ordered to stay home from church, school and theaters and by Dec. 16, saloons were ordered temporarily closed. Schools didn’t reopen until Dec. 30.

On Dec. 23, the city lifted their bans and Dr. Bullock proclaimed, “The epidemic is over if the people will continue to observe precautions against large crowds and follow the personal preventative measures.” In that same breath, he projected cases would likely rise after Christmas. For all intents and purposes, life by Christmas in Kansas City was back to normal, minus the large number of cases of influenza still circulating the city.

Those Who Don’t Learn from the Past. . .

In the last four months of 1918, 1,865 Kansas Citians died from what was coined the Spanish Flu. When cases finally evaporated in Spring 1919, there were over 11,000 cases and around 2,300 deaths. The number of deaths was estimated to be at least 50 million worldwide with about 675,000 occurring in the United States.

Kansas City was one of the hardest hit cities in the country with more cases per capita than New York City, Chicago, and Seattle. St. Louis had one of the lowest cases in the nation due to adhering to a strict quarantine. Division in politics and how to respond to this pandemic in 1918 cost the city greatly.

In the end, history matters. If we don’t learn from history, we are doomed to repeat it. The 1918 flu pandemic may have been lost in the pages of history, rarely referenced by people even with how devastating it truly was. Scientists haven’t forgotten; they reference these responses as a lesson in how to best preserve human lives and respond effectively in the direst circumstances.